Lakes District Seniors Housing Survey
Please take a moment to fill in the survey below. Your individual responses help the Village of Burns Lake to plan for future community needs. Your answers will remain strictly confidential and will only be published in an aggregate form. Thank you for your time.
Personal Information
My Age Group
I live in:
I have lived in the area for:
Where are you living currently?
Are you satisfied with your current living arrangement?
If you answered "no", why?
Your answer
I live:
How long do you plan to stay in your home assuming you have no serious health issues?
If you were to move, what would the reason be?
What would your ideal accommodation be?
What is your preferred housing type?
How many bedrooms would you prefer?
What type of tenure would you prefer?
What type of services do you require in your current home? Select all that apply.
What community services would you like to have close by? Select your top 3 choices
Do you have relatives or friends nearby that you can call on for support when needed?
How much rent would you expect to pay per month for a two bedroom independent living unit?
Do you know if you are eligible for a housing subsidy?
Do you plan to stay in the Lakes District for the next 10 years?
Do you drive?
Rate your current health:
Poor
Excellent
Do you use devices to assist with mobility?
Are stairs difficult?
What is your current income per year?
Written comments you would like to make regarding housing in Burns Lake:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms